Takahashi Yuri, Morimoto Takeshi, Iekushi Kazuma, Arai Hidenori
Medical Affairs Division, Novartis Pharma K.K.
Department of Clinical Epidemiology, Hyogo Medical University.
J Atheroscler Thromb. 2025 Feb 1;32(2):163-175. doi: 10.5551/jat.64848. Epub 2024 Aug 6.
To investigate medication adherence and treatment persistence in patients receiving proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies (mAbs) in Japan.
Using an anonymized claims database from January 2015 to December 2021, data on adult patients at high risk for atherosclerotic cardiovascular disease or with a history of coronary artery disease (CAD) who had at least 1 prescription for PCSK9-mAbs were retrieved.
In total, 276 patients were analyzed. The cumulative treatment persistence rate after 1 year was 67.0%. A multivariate analysis revealed that better adherence to oral low-density lipoprotein cholesterol (LDL-C)-lowering therapy in the year before starting PCSK9-mAbs (adjusted odds ratio [OR] 2.16) and a history of CAD for secondary prevention (adjusted OR 2.44) were associated with better adherence to PCSK9-mAbs in the first year. Better adherence to oral LDL-C-lowering therapy in the year before starting PCSK9-mAbs (adjusted OR 2.32) and a history of CAD for secondary prevention (adjusted OR 3.03) were also associated with a lower rate of discontinuation of PCSK9-mAbs. Age, sex, comorbidity, number of tablets taken daily (all medications), and number of hospital or clinic visits in the year prior to starting PCSK9-mAbs did not affect the persistence rate or adherence to PCSK9-mAbs in the multivariate analyses.
Better adherence to oral LDL-C-lowering therapy and secondary prevention were identified as factors associated with better medication adherence and treatment persistence in patients receiving PCSK9-mAbs within the first year.
调查在日本接受前蛋白转化酶枯草溶菌素9型（PCSK9）单克隆抗体（mAb）治疗的患者的药物依从性和治疗持续性。
利用2015年1月至2021年12月的匿名索赔数据库，检索至少有1次PCSK9 - mAb处方的动脉粥样硬化性心血管疾病高危成年患者或有冠状动脉疾病（CAD）病史的患者的数据。
共分析了276例患者。1年后的累积治疗持续率为67.0%。多变量分析显示，开始使用PCSK9 - mAb前一年对口服低密度脂蛋白胆固醇（LDL - C）降低疗法的更好依从性（调整优势比[OR] 2.16）和二级预防的CAD病史（调整OR 2.44）与第一年对PCSK9 - mAb的更好依从性相关。开始使用PCSK9 - mAb前一年对口服LDL - C降低疗法的更好依从性（调整OR 2.32）和二级预防的CAD病史（调整OR 3.03）也与PCSK9 - mAb停药率较低相关。在多变量分析中，年龄、性别、合并症、每日服用片剂数量（所有药物）以及开始使用PCSK9 - mAb前一年的医院或诊所就诊次数均未影响PCSK9 - mAb的持续率或依从性。
对口服LDL - C降低疗法的更好依从性和二级预防被确定为与接受PCSK9 - mAb治疗的患者在第一年内更好的药物依从性和治疗持续性相关的因素。
